How the world can prepare for the fight against cancer

Here is what we know today: cancer is the second leading cause of death in the world, killing nearly 10 million people in 2018 alone. In addition, population growth and aging will contribute significantly to the rising incidence of cancer worldwide in the coming years. The aging of the population will result in an estimated 63% increase in cancer cases between 2018 and 2040.

In my many years of working with various finance and health ministries to address global health issues, I have found a sense of fatalism about cancer. The public sector may think that it is just too difficult to cope with such a complex and widespread disease. This cancerous fatalism permeates governments and even patients and their families. Preparing countries to better fight against cancer will reduce this fatalism and transform what is inevitably a challenge for health systems into a surmountable reality.

We can ensure that our health systems are sufficiently prepared to fight the disease and reduce mortality in the years to come. This is particularly critical for low- and middle-income countries, which are experiencing rapid growth in cancer incidence but whose health systems are in need, due to the growing triple threat of noncommunicable diseases (NCDs), communicable and a great burden for health.

Cancer is a complex problem that creates distinct and country-specific challenges and opportunities. But while countries need to adopt locally adapted approaches to cope with the epidemic, several key pillars can strengthen our collective capacity to overcome the imminent threat of cancer.

Although most cancers can not be prevented, cost-effective interventions exist to prevent the 30-50% of cancers that we can avoid.

A better overall purchase for cancer prevention seems obvious: stop smoking. Tobacco is the single most important risk factor for cancer and still accounts for 22% of all cancer deaths worldwide. Attacking smoking reduces not only the risk of developing various types of cancers, but also helps improve health and life expectancy. To eliminate smoking, it is often essential to develop good policies and apply them effectively.

There are also several types of cancers that can be prevented by a simple and cost-effective vaccination. About 25% of cancers in low- and middle-income countries are attributed to carcinogenic infections, such as human papillomavirus (HPV) and hepatitis B, that can be prevented by vaccination. The HPV vaccine could reduce by 90% the overall incidence of cervical cancer, while vaccination against hepatitis B would reduce the risk of liver cancer. In fact, Australia announced last year that it was on the verge of being the first country to eradicate cervical cancer, thanks to its HPV vaccination programs in the United States. schools, financed by public funds.

Healthy lifestyle choices also reduce the risk of cancer. Our increasingly sedentary lifestyles, unhealthy diets and the consumption of alcohol increase the risk not only of cancer, but also of noncommunicable diseases such as diabetes and cardiovascular disease. By promoting healthier lifestyles, we reduce the overall burden of disease and free up health care resources to treat other diseases and cancers that can not be prevented.

In addition to implementing the basic principles of prevention, strong delivery systems are essential for effective cancer control. Building early intervention capacity by investing in primary care services helps manage the burden of cancer at a (relatively) low price. Early detection of cancer is largely the responsibility of primary health care providers, making it an essential component of cancer preparedness. According to one study, 85% of cancer cases are detected during a consultation with a primary care clinician. By detecting cancer at an early stage, patients are more likely to fight and survive the disease, reducing unnecessary death and human suffering.

Integrate primary, secondary and tertiary services

Of course, because we can not prevent more than half of all cancers, screening and diagnosis in secondary care is an essential part of the next phase of the fight against cancer. Early screenings such as mammography and intestinal cancer screening help to ensure that cancers are diagnosed and treated early, so that patients have better survival outcomes.

Finally, without effective treatment facilities, low-cost secondary interventions, such as screening and early diagnosis, lose their value. Across the world, even in countries with powerful cancer platforms, there is a need to increase the number of skilled health personnel and to further integrate primary care systems with oncology units.

The development and maintenance of this type of efficient health infrastructure in primary, secondary and tertiary care requires significant investments. However, this investment offers invaluable long-term benefits, including improved quality of life for millions of patients around the world. In fact, I would say that health systems that are effective in fighting cancer are better equipped to fight the majority of chronic diseases.

Developing countries can make different choices to use scarce resources more effectively. For example, even though Thailand lacks specialized cancer personnel, it is doing relatively well in the fight against cancer. This boils down to its strategic focus on all aspects of cancer prevention, including launching immunization campaigns, setting up a tobacco control framework and investing in surveillance tools. disease and cancer research. Rwanda is another good example: it has deliberately chosen to integrate cancer care into its aspirations for universal health coverage.

Last week in Singapore, the Economist Intelligence Unit released the findings of its new report on cancer preparedness around the world and its Cancer Readiness Index (commissioned by Pfizer, Novartis and my employer, Roche). These tools are the first attempt to measure countries' readiness to reduce the number of premature deaths from cancer, increase cancer survival rates and improve the quality of life of patients and survivors.

The importance of effective implementation of cancer control policies is a key element of the report. To do this, it is possible to have an applicable and realistic National Cancer Control Plan (NCCP) that helps countries to choose the best approach to local cancer problems through coordinated efforts between the parties. stakeholders.

However, in many cases, the report revealed that the NCCPs were more ambitious than operational, with high ambitions unmatched to reality and budgets. In some cases, the right policies were in place, but were not implemented effectively. Spain, for example, has strong tobacco control policies, but more than a quarter of Spanish adults smoke and this rate is increasing.

To be effective, NCCPs need to focus on the specific needs of the population covered in cancer, set realistic goals and budgets, and engage all relevant stakeholders. Early data indicates the effectiveness of a strong and well implemented NCCP in reducing cancer mortality.

The task ahead is not easy and the public sector alone can not meet the challenge of cancer. The entire cancer ecosystem, including civil society and the private sector, should be part of the solution. That's why I'm proud that Roche is contributing to ongoing political dialogue and public-private partnerships. Through this important cross-sectoral dialogue on access to health care and our contribution to the Union's "Cancer City Challenge 2025" for cancer control, we collaborate with city and community governments. other stakeholders to increase visibility and commitment to improve cancer care at the municipal level. .

The continual increase in cancer is inevitable. However, if we adhere to the essential pillars of preparedness and work closely together, we can compensate for its impact on millions of people around the world.

The opinions expressed in this article are binding only on the author and not the World Economic Forum.